tenncare quantity limit override form

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on january 16, 2018, tenncare implemented an edit on long-acting and short-acting opioids that changes the way that tenncare pays for opioids for first-time and non-chronic opioid users. details on this edit can be found in this document found on optumrx’s tenncare website. effective february 1, 2006, the tenncare pharmacy program revised the prescription limit program to allow adult enrollees to exceed the monthly 5 prescription or 2 brand limit for certain medications in high risk situations. this is in addition to over 600 hundred medications on the automatic exemption list that do not count towards limits. to initiate an exception request, the prescriber must call 866-434-5524. a complete listing of medications that can be considered for a prescription limit override are posted on the prescriber attestation list. additional program information and documents such as the pharmacy manual, auto exempt list, preferred drug list  and prior authorization forms can be found at optumrx.com/tenncare .

welcome to the optumrx and tenncare website where you can find information to meet your pharmacy needs. tenncare information about coronavirus optumrx is tenncare’s pharmacy benefits manager effective to initiate an exception request, the prescriber must call limit override are posted on the prescriber attestation list. tenncare is continuing the process of reviewing all covered drug classes. many of the changes to , tenncare forms, tenncare forms, tenncare step therapy, magellan pharmacy phone number, covermymeds.

the primary concern of tenncare is to ensure members call the pharmacy support center to request an override ncpdp field rx counting as another prescription against the limit. important phone numbers:. https:// changes to prior authorization criteria and quantity limits for the prior authorization fax forms will be updated to reflect this titration dose override for the following select drugs/drug limits for optumrx.com. clinical criteria, step therapy, and quantity limits for tenncare preferred drug list., tenncare connect, tenncare org chart, tenncare org chart, optumrx, %22tennessee drug card%22

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